‘Barbaric and inhumane’: Is it time gynaecological procedures came with pain relief?

First published on June 3, 2021

Women’s pain being disregarded by medical professionals is not new.

But a wave of recent conversations has highlighted the shared suffering of thousands – with many realising for the first time they are not alone in having undergone traumatic gynaecological procedures.

“Barbaric” and “inhumane” are just some of the disturbing terms used by dozens of women who have bravely shared their stories with The Flock this week, relating to the insertion and removal of IUDs – a contraceptive device placed into the womb to prevent pregnancy ­– cervical biopsies, and hysteroscopies, a procedure to examine the womb.

The stories have a common theme: “excruciating” pain, due to not being given adequate painkillers, if any. People regularly report not feeling properly informed or listened to by medical professionals, and some patients even say they were laughed at or called hysterical when they were distressed.

Women now have the opportunity to share these experiences as evidence for a government survey, which promises to shape the future of female healthcare. The Women’s Health Strategy has already had more than 80,000 respondents and has been extended until June 13 to allow for more. Is this the chance women have been waiting for to make their voices, and their pain, heard?

When Lucy Cohen went to have a copper IUD fitted in May, she read on the NHS website that the procedure might be “uncomfortable…but you can take painkillers after, if you need to.” She asked her GP for painkillers and was told paracetamol “should be enough”.

However, the 38-year-old from Swansea found herself in “unbearable” pain as it took three attempts to fit the copper coil due to her tilted cervix, something that affects approximately one in five women.

“I have never felt pain like it. It was terrifying,” the accountant says. “I didn’t recognise the sounds coming out of my mouth.”

Cohen says she was left “lying on the sofa dumbstruck and sobbing” for a week after. As a self-proclaimed “over-sharer”, she decided to ask friends if they had experienced something similar. Overwhelmed by the responses, she decided to create her own survey asking people about their experiences with the insertion and removal of IUDs.

To date, more than 1,200 people have responded. Pain relief was not discussed with or offered as standard to 56% of the survey’s respondents, while 71% said they were not prepared for the reality of the procedure. An incredible 93% said they experienced pain, with 43% rating their pain in the top three of 11 options: “extremely painful”, “almost unbearable” and “excruciating”.

“There is a real problem here,” Cohen says. “Our findings highlight that people with uteruses are gaslighted in medicine. Our pain isn’t listened to.”

“Also, women aren’t taught to question things – they are just expected to grin and bear it. These issues are still taboo.”

Cohen has now launched a Change.org petition, calling for more information and more pain options for IUD procedures – the petition which was then shared in the newsletter of activist Caroline Criado Perez, alongside her own “horrendous” IUD experience where she was given no pain relief. Criado Perez described how her cervix “went into spasm” as her IUD was removed, before three people struggled to put in a new one. “I was made to feel like this was somehow my fault for having a ‘difficult’ cervix,” she added. When an expert was finally brought in, she was “in excruciating pain and thoroughly traumatised”.

Days later, the Invisible Women author tweeted she had received several responses, many of them prefaced by caveats about pain thresholds and childbirth. “Women are so used to being disbelieved about pain that we feel the need to accompany our experiences with proof how much pain we can handle,” she added.

Journalist Caitlin Moran also shared her story, writing on Twitter: “During my last IUD insertion – with an inexperienced nurse – the pain was so bad I fainted twice and they had to invert the examining table, then give me Lucozade. LUCOZADE! I WANTED AN EPIDURAL. THEY WERE OPENING MY CERVIX AND INSERTING A DOLLS’ COATHANGER!”

She later added: “If IUDs went up willies, there would be MORPHINE.”

These tweets sparked a wave of hundreds of women sharing their experiences of “routine” gynaecological procedures. Most poignant perhaps were those who echoed the sentiment of isolation, the feeling that “I thought it was just me.”

Another group working tirelessly in the fight for adequate pain relief and information for women is the Campaign Against Painful Hysteroscopy, whose petition ‘End barbaric NHS hysteroscopies with inadequate pain-relief’ has more than 50,000 signatures.

The group has collected hundreds of stories of “severely painful NHS outpatient hysteroscopies performed with no or inadequate pain-relief,”  and reports speaking to a host of patients who have gone on to suffer PTSD.

Philippa Hammond, a member of the campaign from Brighton, shared her experience of a traumatic hysteroscopy, telling The Flock: “I am angry about the lack of care – not the medical expertise, but the failure of empathy, communication and consideration for the human being.

“This inhumane NHS practice of subjecting women to invasive surgery with no proper explanation, anaesthetic or full consent must end now. This is assault.”

Denise Sam, 50, from Walthamstow, London, underwent a biopsy with no pain management and has complained about an “incredibly dismissive” consultant’s “shockingly inappropriate” comment about the relaxation techniques she used to try to manage the pain herself. She says the procedure ended early because of a risk of her womb being perforated and she was advised to return to have it later under general anaesthetic. “I was in shock,” Sam says now. “I went home and recognised I was experiencing PTSD reactions such as flashbacks and distress. I slept most of the day and the following one.”

Aimee Love, 39, from Lichfield, Staffordshire, says she “felt like I’d been stabbed” when she underwent an IUD insertion in 2010. Eleven years later, she still suffers from chronic pain and PTSD. “I lost my career and had to give up full time work,” she says. “It affected my relationship, our sex life, our ability to have children, our finances, everything.”

In contrast to these female-specific procedures, patients undergoing similar, non-gendered procedures such as colonoscopies are regularly offered sedation or gas and air as standard. Now, patients who have experienced this imbalance are being urged to document their experiences as part of a government survey it’s hoped can help shape the future of female healthcare.

Participants in the Government survey, which is open only to people in England, can choose the areas they want to give evidence on and share their experiences of when they felt they were not listened to by health professionals.

Nadine Dorries, minister for women’s health, said: “For generations, we have lived with a health care system designed by men, for men. This means women’s issues are often marginalised, such as the impact of female-specific health conditions.

“It’s time we change that – we are committed to making sure the healthcare system is really meeting women’s needs. I urge all women to tell us their experiences and views in our call for evidence so we can put their voices at the centre of our Women’s Health Strategy and make sure our future policies work for them.

“I promise we are listening.”